The Patient Journey

Facing breast cancer treatment can be overwhelming. Our team is here to help you understand the steps of your treatment plan and to answer any questions you may have. Different types of breast conditions and cancers may mean different types of treatment. We work with you during your first appointments to develop a treatment plan personalized for you, your diagnosis and your individual needs.

On this page:

Before a diagnosis

You may have a worrisome symptom, or a routine screening mammogram may show something unusual.

The first step is a clinical exam, painless diagnostic imaging such as magnetic resonance imaging (MRI) or ultrasound and possibly a biopsy. You can contact us to schedule a diagnostic appointment or work with your primary care provider to request a referral to our office.

Biopsy

There are two types of biopsies you may have—a core biopsy or a surgical biopsy.  If you have a core biopsy, you receive the pathology results from the diagnostic radiologist who performed the biopsy. If you have a surgical biopsy, you receive the pathology results from the surgeon who performed the biopsy.

You may receive your diagnosis over the phone or in person. We contact you promptly to arrange a meeting with our providers to discuss your treatment options.

For a second opinion from us

If you have already been diagnosed outside of the Dartmouth Health system and you want to receive a second opinion or treatment here, please contact us. We request background information including medical records, imaging and pathology slides for our team of experts to review before your first appointment.

After a diagnosis

If you receive a diagnosis of breast cancer, our team of medical experts meets with you promptly to discuss your case. We review your medical history, diagnostic imaging, and biopsy results. Then we discuss our recommendations for your treatment. We schedule your first consultation with the member of our team whose expertise is the best fit for your case. Most of our patients with breast cancer see a surgeon first.

Before your first appointment, you’ll receive a packet of information. The packet includes a schedule of your appointments and our Breast Cancer Treatment Handbook. We encourage you to sign up for our patient portal, myDH. MyDH allows you to:

  • Access information about your appointments, provider notes and test results at any time
  • Ask questions and communicate with your providers
  • View the BCT Handbook and patient education videos

Patient coordinators and schedulers make every effort to coordinate your appointments to reduce burdens on you and your care partners. If you need help with lodging or travel, we connect you with our social worker.

Your treatment plan

Our full team of breast care experts from many departments works together to develop your treatment plan. Each of the treatments we recommend for you is tailored to the type and stage of cancer with which you have been diagnosed.

Also, as part of the gold standard of optimal cancer care, we review all cases for possible clinical trial eligibility. If you are eligible for any research studies, a member of the research team may contact you to explain more about the opportunity.

After active treatment

After you complete active treatment (chemotherapy, immunotherapy, radiation therapy, surgery, or targeted therapy) for your breast cancer we continue to support you through your recovery.

Many types of breast cancer require medications to continue for 1 to 10 years after diagnosis. Ongoing checkups during this time are less intensive, but a very important phase of treatment.

If you still have breast tissue, you will have a screening mammogram every year. Some people also get additional screening tests like breast MRI. You have a follow-up visit and breast exam with your surgery team at this time.

If your treatment included:

  • Radiation, you see a radiation oncology provider for follow-up as long as necessary to address any questions or concerns you may have related to your radiation treatments.
  • Systemic therapy (chemotherapy, hormonal therapy, or immunotherapy), you see a medical oncology provider for follow-up.

As you get further out from your diagnosis, your appointments may be with the nurse practitioners and physician assistants on your care team. This allows us to continue to see new patients while still providing you with excellent long-term oncology care. Our Complementary Care Program offers well-being support at any time, from diagnosis long into survivorship.